Long-standing systemic social, economic, and environmental inequities in the United States have put many communities of color (racial and ethnic minority groups) at increased risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, as well as more severe COVID-19-related outcomes (1-3). Because race and ethnicity are missing for a proportion of reported COVID-19 cases, counties with substantial missing information often are excluded from analyses of disparities (4). Thus, as a complement to these case-based analyses, population-based studies can help direct public health interventions. Using data from the 50 states and the District of Columbia (DC), CDC identified counties where five racial and ethnic minority groups (Hispanic or Latino [Hispanic], non-Hispanic Black or African American [Black], non-Hispanic Asian [Asian], non-Hispanic American Indian or Alaska Native [AI/AN], and non-Hispanic Native Hawaiian or other Pacific Islander [NH/PI]) might have experienced high COVID-19 impact during April 1-December 22, 2020. These counties had high 2-week COVID-19 incidences (>100 new cases per 100,000 persons in the total population) and percentages of persons in five racial and ethnic groups that were larger than the national percentages (denoted as "large"). During April 1-14, a total of 359 (11.4%) of 3,142 U.S. counties reported high COVID-19 incidence, including 28.7% of counties with large percentages of Asian persons and 27.9% of counties with large percentages of Black persons. During August 5-18, high COVID-19 incidence was reported by 2,034 (64.7%) counties, including 92.4% of counties with large percentages of Black persons and 74.5% of counties with large percentages of Hispanic persons. During December 9-22, high COVID-19 incidence was reported by 3,114 (99.1%) counties, including >95% of those with large percentages of persons in each of the five racial and ethnic minority groups. The findings of this population-based analysis complement those of case-based analyses. In jurisdictions with substantial missing race and ethnicity information, this method could be applied to smaller geographic areas, to identify communities of color that might be experiencing high potential COVID-19 impact. As areas with high rates of new infection change over time, public health efforts can be tailored to the needs of communities of color as the pandemic evolves and integrated with longer-term plans to improve health equity.

中文翻译：

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2020年4月1日至12月22日，美国COVID-19发病率较高且种族和少数民族人口相对较多的县。

在美国，长期存在的系统性社会，经济和环境不平等现象使许多有色人种（种族和少数族裔群体）暴露于SARS-CoV-2（引起COVID-19的病毒）并受到其感染的风险增加。 ，以及更严重的COVID-19相关结果（1-3）。由于在报告的COVID-19病例中有一定比例的种族和种族缺失，因此对差异性进行分析的国家往往被排除在外，而那些信息严重缺失的县通常会被排除在外（4）。因此，作为对这些基于案例的分析的补充，基于人群的研究可以帮助指导公共卫生干预措施。疾病预防控制中心使用来自50个州和哥伦比亚特区（DC）的数据，确定了五个种族和少数民族群体（西班牙裔或拉丁裔[Hispanic]，非西班牙裔黑人或非裔美国人[Black]，非西班牙裔亚洲人[Asian]，非西班牙裔美洲印第安人或阿拉斯加原住民[AI / AN]和非西班牙裔夏威夷原住民或其他太平洋岛民[NH / PI]）在4月1日对COVID-19的影响可能很大2020年12月22日。这些县的两周COVID-19发病率很高（每100万人中有100例新病例），并且五个种族和族裔群体中的人口百分比均高于全国百分比（称为“大”）。在4月1日至14日期间，美国3,142个县中的359个（11.4％）报告了高COVID-19发病率，其中28.7％的县的亚裔人口比例较高，而27.9％的县的黑人比例较高。在8月5日至18日期间，有2,034（64.7％）个县（包括92个）报告了高COVID-19发病率。黑人占较大比例的县占4％，西班牙裔占较大比例的县占74.5％。在12月9日至22日期间，报告了3,114个县（99.1％）高COVID-19发病率，其中包括> 95％的五个族裔和少数族裔人群中有很大比例的人群。这种基于人群的分析结果与基于案例的分析相辅相成。在种族和种族信息严重缺失的辖区中，可以将这种方法应用于较小的地理区域，以识别可能受到COVID-19潜在高影响的有色社区。随着新感染率高的地区随时间而变化，随着大流行的发展，公共卫生工作可以针对有色社区的需求进行调整，并与长期计划相结合，以改善卫生公平性。